The March 14 internal memo, signed by chief of surgery Dr. David Tees, instructs doctors to refer their patients to oncology, respirology or GI for now, "depending on the clinical situation for initial workup and tissue diagnosis."

A "thoracic disposition" group has also been established to review cases and refer to a surgeon "if indicated," according to the memo, obtained by CBC News.

The group plans to meet twice monthly, starting on March 22, it states.

"It is our hope that this system will provide patients with timely access and diagnosis," wrote Tees.

Biweekly teleconferencing with an unidentified thoracic surgeon is also expected to start on March 22 and Tees lists nine surgeons in New Brunswick, Nova Scotia and Quebec who "may be called upon to see a patient in consultation."

Three of the four listed for New Brunswick are general surgeons located in Fredericton, Moncton and Edmundston, according to the provincial College of Physicians and Surgeons registry, while the fourth is an internal and respiratory medicine specialist in Moncton.

The general surgeon in Fredericton, however, has an asterisk beside his name in the memo, indicating "presently full and would prefer no more for now."

Earlier this week, a 65-year-old Saint John woman with esophageal cancer told CBC News her gastroenterologist referred her to four different surgeons in New Brunswick and Nova Scotia and she was turned away by all of them.

"It's really scary," said Eileen Shaw, who is having difficulty getting food past the growing tumour in her throat.

"I'm thinking, 'Oh my goodness, where am I going to go? Am I going to die?'

Tees says Horizon's general surgeons are also providing after-hour coverage "as they have in the past when we have been without a thoracic surgeon."

"Let me know if you have any problems with this temporary solution to triaging patients," he wrote.

A Horizon Health official is expected to provide an update on the situation to the media on Friday at 11 a.m. in Fredericton.